In-home contextual reality: a qualitative analysis using the Multiple Errands Test Home Version (MET-Home)

Area of Science:

• Neurology
• Rehabilitation Science
• Environmental Psychology

Background:

• Executive dysfunction is common in adults post-stroke, affecting daily task performance.
• Existing assessments often lack ecological validity, failing to capture real-world environmental influences.
• The MET-Home offers an ecologically valid method for assessing executive function in the home environment.

Purpose of the Study:

• To explore the interplay between the home environment and performance on the MET-Home assessment in adults post-stroke.
• To identify environmental supports and barriers influencing executive function in a community setting.
• To understand how the environment is utilized as a strategy to manage executive dysfunction.

Main Methods:

• Descriptive qualitative approach using video, interview, and observation data from a MET-Home validation study.
• Analysis of naturally occurring interactions between participants and their home environments.
• The study included home-dwelling adults post-stroke and matched controls.

Main Results:

• An overarching theme of 'interplay between everyday task performance and the home environment' emerged.
• Sub-themes included 'naturalistically emerging supports and barriers' (physical, social, temporal, virtual, personal contexts) and 'environment as strategy' (reducing distractions, using technology, planning, social support).

Conclusions:

• The home environment significantly influences executive function performance post-stroke.
• Assessment and rehabilitation should consider the dynamic interaction between individuals and their specific environments.
• Future evaluations of executive dysfunction must incorporate environmental factors for comprehensive understanding and effective intervention.